Individual
KIMBERLY CARMICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
6217 S PACKARD AVE, CUDAHY, WI 53110-3096
(414) 764-5550
(414) 764-9198
Mailing address
406 LINDGREN LN, BELVIDERE, IL 61008-7065
(815) 721-0929
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1001312-15
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/25/2016
Last updated
06/06/2016
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